You walk in at night, your horse is pawing, looking at his flank, and that uneasy feeling hits your stomach. Most owners lose time right here by waiting for one more sign. Don’t. Start checking things now and call early with real numbers.
Heart rate first. In a normal adult horse, you’re often around 28-44 bpm. If it is sitting above 60 and the horse is still painful, that is not a “let’s see in an hour” number. Then look at gums. You want pink and moist, not dark or tacky. Press and release: refill should be under two seconds. While you’re doing this, notice breathing effort and whether manure is passing. None of these in isolation makes the diagnosis; together they tell you whether the case is drifting the wrong way.
When you call, be blunt and specific: when it started, current heart rate, gum/CRT findings, manure status, and how the pain is changing. “He’s uncomfortable” is vague. “Started 40 minutes ago, HR 64, tacky gums, no manure since afternoon, still trying to go down” is useful. That difference matters more than people realize.
The cases that scare me are often the ones that tease owners with a short calm period. Pain eases for a bit, everyone exhales, then it comes back harder. So yes, mild gas colics happen and some resolve. But temporary improvement does not guarantee safety, especially when heart rate and perfusion signs stay ugly. Trend over time beats one reassuring moment.
Also, protect yourself. A horse in severe abdominal pain can move unpredictably and fast. If rolling becomes violent, don’t trap yourself in a stall corner trying to physically control 1,200 pounds of panic. Walking can help in some cases, but forced nonstop walking is not treatment and can make a bad scene worse. Keep it calm, keep it safe, keep communicating.
Most prevention is boring barn discipline: no abrupt feed changes, guard winter hydration, keep parasite control evidence-based, watch for sand exposure where that’s a local issue, and don’t let dental pain drag on until chewing quality drops. None of that is glamorous, but it quietly prevents 2 a.m. chaos.
Bottom line: if the horse is still painful and the heart rate stays high, escalate. Early, accurate reporting gives your vet a better chance to make the right call before the case outruns you.
For the next step, start with winter hydration risk if water intake has dipped. If your core question is escalation timing, use the owner triage framework. For prevention planning, review the dental schedule guide.
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Winter Horse Hydration: Why Colic Risk Rises and How to Prevent It • Hoof Abscess in Horses: First 48 Hours and When to Call the Vet • Equine Dental Floating: Age-Based Schedule and Owner Warning Signs